Stage 0 Esophageal Cancer

Overview

Patients with stage 0 esophageal cancer have carcinoma in situ, which is characterized by cancer cells that involve only the superficial (top) layer of cells lining the esophagus. Although these are usually small cancers, they may, on occasion, spread superficially and involve a large part of the esophagus.

A variety of factors ultimately influence a patient’s decision to receive treatment of cancer. The purpose of receiving cancer treatment may be to improve symptoms through local control of the cancer, increase a patient’s chance of cure, or prolong a patient’s survival. The potential benefits of receiving cancer treatment must be carefully balanced with the potential risks of receiving cancer treatment.

The following is a general overview of the treatment of stage 0 esophageal cancer. Circumstances unique to your situation and prognostic factors of your cancer may ultimately influence how these general treatment principles are applied to your situation. The information on this Web site is intended to help educate you about your treatment options and to facilitate a mutual or shared decision-making process with your treating cancer physician.

Most new treatments are developed in clinical trials. Clinical trials are studies that evaluate the effectiveness of new drugs or treatment strategies. The development of more effective cancer treatments requires that new and innovative therapies be evaluated with cancer patients. Participation in a clinical trial may offer access to better treatments and advance the existing knowledge about treatment of this cancer. Clinical trials are available for most stages of cancer. Patients who are interested in participating in a clinical trial should discuss the risks and benefits of clinical trials with their physician. To ensure that you are receiving the optimal treatment of your cancer, it is important to stay informed and follow the cancer news in order to learn about new treatments and the results of clinical trials.

Stage 0 esophageal cancer is rare in the United States, but is more common in Asia, where patients at risk of developing esophageal cancer are subjected to routine periodic esophagoscopy. Treatment for stage 0 esophageal cancer involves surgical resection with wide margins. If there is no superficial spread, most stage 0 cancers can be removed through an endoscope. The cure rate is greater than 90%.

Strategies to Improve Treatment

Since this is such an unusual presentation for cancer of the esophagus in the United States, there are essentially no new strategies directed specifically at treatment; however photodynamic therapy may be an option.

Photodynamic treatment: Photodynamic ablation has been used for the palliation of patients with esophageal cancer. Photodynamic treatment involves injection of a light sensitizer into a vein, which is then taken up by cells. A laser is then directed at the cancer cells. The reaction between the laser and the light sensitizer destroys the cells. The objective response rate at one month with this approach has been reported to be 32% for patients receiving photodynamic laser treatment, which compared favorably to the 20% reported for patients receiving thermal-laser treatment.